BACKGROUND/OBJECTIVES: Quercetin (QT) is a plant flavonoid that offers health benefits owing to its various bioactive properties; however, as a hydrophobic substance, it has considerably low bioavailability. We previously demonstrated that QT nanoemulsion (QT+NE) formulated via oil-in-water nanoemulsification exhibited more effective cholesterollowering activity than ordinary QT in high cholesterol-fed rats. In this study, we investigated the effects of QT+NE on the regulation of skeletal muscle mitochondrial function in high-fat diet (HD)-fed mice.MATERIALS/METHODS: C57BL/6J mice were fed a normal chow diet (ND), HD (45% of calories from fat), or HD with 0.05% QT+NE or QT for 11 weeks. We analyzed sirtuin 1 (SIRT1) activation, mitochondrial changes, and the expression of genes involved in mitochondrial biogenesis in skeletal muscle. RESULTS: Body weight and body weight gain decreased in the QT+NE group compared with that in the HD group (P < 0.05), but not in the QT group. Epididymal adipose tissue weight decreased in both the QT and QT+NE groups (P < 0.05). Plasma lipid levels also improved in both the QT and QT+NE groups (P < 0.05). QT+NE intake upregulated the messenger RNA levels of SIRT1, peroxisome proliferator-activated receptor-γ coactivator 1-α, nuclear respiratory factor 1, and mitochondrial transcription factor A in skeletal muscle compared with HD intake alone (P < 0.05), whereas QT did not. In particular, SIRT1 activity was significantly increased in the QT+NE group compared with that in the QT group (P < 0.05).HD intake reduced mitochondrial DNA content compared with ND intake; nevertheless, QT+NE intake retained it (P < 0.05). CONCLUSION Collectively, our findings suggest that QT+NE may be beneficial in enhancing mitochondrial biogenesis in skeletal muscle of HD-fed mice, which may be associated with SIRT1 activation.

BACKGROUND/OBJECTIVES: Quercetin (QT) is a plant flavonoid that offers health benefits owing to its various bioactive properties; however, as a hydrophobic substance, it has considerably low bioavailability. We previously demonstrated that QT nanoemulsion (QT+NE) formulated via oil-in-water nanoemulsification exhibited more effective cholesterollowering activity than ordinary QT in high cholesterol-fed rats. In this study, we investigated the effects of QT+NE on the regulation of skeletal muscle mitochondrial function in high-fat diet (HD)-fed mice.MATERIALS/METHODS: C57BL/6J mice were fed a normal chow diet (ND), HD (45% of calories from fat), or HD with 0.05% QT+NE or QT for 11 weeks. We analyzed sirtuin 1 (SIRT1) activation, mitochondrial changes, and the expression of genes involved in mitochondrial biogenesis in skeletal muscle. RESULTS: Body weight and body weight gain decreased in the QT+NE group compared with that in the HD group (P < 0.05), but not in the QT group. Epididymal adipose tissue weight decreased in both the QT and QT+NE groups (P < 0.05). Plasma lipid levels also improved in both the QT and QT+NE groups (P < 0.05). QT+NE intake upregulated the messenger RNA levels of SIRT1, peroxisome proliferator-activated receptor-γ coactivator 1-α, nuclear respiratory factor 1, and mitochondrial transcription factor A in skeletal muscle compared with HD intake alone (P < 0.05), whereas QT did not. In particular, SIRT1 activity was significantly increased in the QT+NE group compared with that in the QT group (P < 0.05).HD intake reduced mitochondrial DNA content compared with ND intake; nevertheless, QT+NE intake retained it (P < 0.05). CONCLUSION Collectively, our findings suggest that QT+NE may be beneficial in enhancing mitochondrial biogenesis in skeletal muscle of HD-fed mice, which may be associated with SIRT1 activation.

BACKGROUND/OBJECTIVES: Quercetin (QT) is a plant flavonoid that offers health benefits owing to its various bioactive properties; however, as a hydrophobic substance, it has considerably low bioavailability. We previously demonstrated that QT nanoemulsion (QT+NE) formulated via oil-in-water nanoemulsification exhibited more effective cholesterollowering activity than ordinary QT in high cholesterol-fed rats. In this study, we investigated the effects of QT+NE on the regulation of skeletal muscle mitochondrial function in high-fat diet (HD)-fed mice.MATERIALS/METHODS: C57BL/6J mice were fed a normal chow diet (ND), HD (45% of calories from fat), or HD with 0.05% QT+NE or QT for 11 weeks. We analyzed sirtuin 1 (SIRT1) activation, mitochondrial changes, and the expression of genes involved in mitochondrial biogenesis in skeletal muscle. RESULTS: Body weight and body weight gain decreased in the QT+NE group compared with that in the HD group (P < 0.05), but not in the QT group. Epididymal adipose tissue weight decreased in both the QT and QT+NE groups (P < 0.05). Plasma lipid levels also improved in both the QT and QT+NE groups (P < 0.05). QT+NE intake upregulated the messenger RNA levels of SIRT1, peroxisome proliferator-activated receptor-γ coactivator 1-α, nuclear respiratory factor 1, and mitochondrial transcription factor A in skeletal muscle compared with HD intake alone (P < 0.05), whereas QT did not. In particular, SIRT1 activity was significantly increased in the QT+NE group compared with that in the QT group (P < 0.05).HD intake reduced mitochondrial DNA content compared with ND intake; nevertheless, QT+NE intake retained it (P < 0.05). CONCLUSION Collectively, our findings suggest that QT+NE may be beneficial in enhancing mitochondrial biogenesis in skeletal muscle of HD-fed mice, which may be associated with SIRT1 activation.

BACKGROUND/OBJECTIVES: Quercetin (QT) is a plant flavonoid that offers health benefits owing to its various bioactive properties; however, as a hydrophobic substance, it has considerably low bioavailability. We previously demonstrated that QT nanoemulsion (QT+NE) formulated via oil-in-water nanoemulsification exhibited more effective cholesterollowering activity than ordinary QT in high cholesterol-fed rats. In this study, we investigated the effects of QT+NE on the regulation of skeletal muscle mitochondrial function in high-fat diet (HD)-fed mice.MATERIALS/METHODS: C57BL/6J mice were fed a normal chow diet (ND), HD (45% of calories from fat), or HD with 0.05% QT+NE or QT for 11 weeks. We analyzed sirtuin 1 (SIRT1) activation, mitochondrial changes, and the expression of genes involved in mitochondrial biogenesis in skeletal muscle. RESULTS: Body weight and body weight gain decreased in the QT+NE group compared with that in the HD group (P < 0.05), but not in the QT group. Epididymal adipose tissue weight decreased in both the QT and QT+NE groups (P < 0.05). Plasma lipid levels also improved in both the QT and QT+NE groups (P < 0.05). QT+NE intake upregulated the messenger RNA levels of SIRT1, peroxisome proliferator-activated receptor-γ coactivator 1-α, nuclear respiratory factor 1, and mitochondrial transcription factor A in skeletal muscle compared with HD intake alone (P < 0.05), whereas QT did not. In particular, SIRT1 activity was significantly increased in the QT+NE group compared with that in the QT group (P < 0.05).HD intake reduced mitochondrial DNA content compared with ND intake; nevertheless, QT+NE intake retained it (P < 0.05). CONCLUSION Collectively, our findings suggest that QT+NE may be beneficial in enhancing mitochondrial biogenesis in skeletal muscle of HD-fed mice, which may be associated with SIRT1 activation.

BACKGROUND/OBJECTIVES: Quercetin (QT) is a plant flavonoid that offers health benefits owing to its various bioactive properties; however, as a hydrophobic substance, it has considerably low bioavailability. We previously demonstrated that QT nanoemulsion (QT+NE) formulated via oil-in-water nanoemulsification exhibited more effective cholesterollowering activity than ordinary QT in high cholesterol-fed rats. In this study, we investigated the effects of QT+NE on the regulation of skeletal muscle mitochondrial function in high-fat diet (HD)-fed mice.MATERIALS/METHODS: C57BL/6J mice were fed a normal chow diet (ND), HD (45% of calories from fat), or HD with 0.05% QT+NE or QT for 11 weeks. We analyzed sirtuin 1 (SIRT1) activation, mitochondrial changes, and the expression of genes involved in mitochondrial biogenesis in skeletal muscle. RESULTS: Body weight and body weight gain decreased in the QT+NE group compared with that in the HD group (P < 0.05), but not in the QT group. Epididymal adipose tissue weight decreased in both the QT and QT+NE groups (P < 0.05). Plasma lipid levels also improved in both the QT and QT+NE groups (P < 0.05). QT+NE intake upregulated the messenger RNA levels of SIRT1, peroxisome proliferator-activated receptor-γ coactivator 1-α, nuclear respiratory factor 1, and mitochondrial transcription factor A in skeletal muscle compared with HD intake alone (P < 0.05), whereas QT did not. In particular, SIRT1 activity was significantly increased in the QT+NE group compared with that in the QT group (P < 0.05).HD intake reduced mitochondrial DNA content compared with ND intake; nevertheless, QT+NE intake retained it (P < 0.05). CONCLUSION Collectively, our findings suggest that QT+NE may be beneficial in enhancing mitochondrial biogenesis in skeletal muscle of HD-fed mice, which may be associated with SIRT1 activation.

Allergen immunotherapy (AIT) has been used for over a century and has been demonstrated to be effective in treating patients with various allergic diseases. AIT allergens can be administered through various routes, including subcutaneous, sublingual, intralymphatic, oral, or epicutaneous routes. Sublingual immunotherapy (SLIT) has recently gained clinical interest, and it is considered an alternative treatment for allergic rhinitis (AR) and asthma. This review provides an overview of the current evidence-based studies that address the use of SLIT for treating AR, including (1) mechanisms of action, (2) appropriate patient selection for SLIT, (3) the current available SLIT products in Korea, and (4) updated information on its efficacy and safety. Finally, this guideline aims to provide the clinician with practical considerations for SLIT.

Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.

This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively.Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques.There has been a decrease in intravenous thrombolysis rates, from 12% in 2017–2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for noncardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

Background: Despite the popularity of the NeoBase 2 Non-derivatized MSMS assay (PerkinElmer, Turku, Finland), there are no reports of its comprehensive evaluation, including the ability to distinguish transient tyrosinemia of the newborn (TTN) from tyrosinemia type 1 (TYR 1) using succinylacetone (SUAC). No newborn screening (NBS) cutoffs for preterm neonates in the Korean population have been suggested. We evaluated the NeoBase 2 assay and identified analytes requiring different cutoffs in preterm neonates. Methods: Residual NBS dried blood spot samples and proficiency testing (PT) materials of the Newborn Screening Quality Assurance Program and the Korean Association of External Quality Assessment Service were used. Precision, accuracy, limit of detection (LOD), lower limit of quantification (LLOQ), linearity, recovery, carryover, and performance of SUAC were evaluated. Cutoffs were determined, and analytes requiring different cutoffs in preterm neonates were investigated. Results: Mean CVs for within-run and between-day precision were within 15%. Accuracy analysis indicated high agreement with in-house derivatized assay results and results of other PT participants. All analytes demonstrated acceptable LOD, LLOQ, and linearity. Recoveries were acceptable, except for SUAC. Carryover was negligible. Cutoffs were established for all analytes; Tyr, adenosine, and C20:0-lysophosphatidylcholine required different cutoffs in preterm neonates. Differential diagnosis of TYR 1 and TTN was successful with simultaneous Tyr and SUAC measurement. Conclusions The NeoBase 2 assay demonstrated satisfactory performance. The additional analytes provide a wider diagnostic coverage, and the simultaneous measurement of Tyr and SUAC is efficient in excluding TYR 1. The new cutoffs for preterm neonates may decrease false-positive rates, without compromising diagnostic sensitivity.